Tachycardia and Pheochromocytoma?

[Hollymist]

I am a 39 y.o. female with sarcoidosis, MVP, and fibromyalgia. I have had sinus tachycardia since the onset of Sarcoidosis in 1989. I started having a constant pressure in my head in May 2000, and when I attempt to do any type of exertional exercise I get a throbbing headache, and a heart rate of 180 within 2 minutes. I am currently off work on disability due to the h/a's and severe fatigue. My resting heart rate stays around 110 without meds, and around 100 with Toprol 25 mg (1/2 tab). I did have a stress test recently, and the Dr. terminated it at 3 1/2 min. due to the tachycardia and my symptoms. I have a very poor exercise tolerance, and it takes about an hour to recover from the headaches after exercising. The cardiologist states that I had no ischemic EKG changes, but that he thinks I should be worked up for a pheochromocytoma. He also wants me to increase the Toprol to 25 mg 2 x day, but I feel even more tired, and occasionally dizzy with that. He wants my Internist to do the Pheo workup, and I also am waiting to see a neurologist next month. Do you think this sounds like a pheochromocytoma, or do you have any other ideas? Thanks!

[ahmedmamun]

A related discussion, sinus trachycardia was started.

[wezo01]

A related discussion, Sinus tachycardia in Pheochromocytoma was started.

[zak]

I'm in pretty much the same situation and I've had the blood test for a pheo.  I'd kinda disagree that those tests are simple cuz I test positive on catecholamines, VMA and nor/metanephrines but nobody can find a tumour.  Stress can probably throw the tests I would guess.  And equally I know many others with a negatie test who ended up having a pheo -- they can be intermittent releases or hormones.

[Cleveland Clinic, MD]

Dear Hollymist,
Well pheochromocytoma is in the differential diagnosis of tachycardia and high blood pressure but it is rather rare.  I would agree that you should be evaluated as it is rather a simple test - urine colection and blood test.  Other potential causes include inappropriate sinus tachycardia, postural orthostatic hypotention (POTs) and deconditioning.